?151
"No. 74 OF 1882,
GADAG DISPENSARY, DHA'RWA'R ZILLAH.
To
THE SECRETARY TO THE SURGEON GENERAL
WITH THE GOVERNMENT OF BOMBAY,
BOMBAY.
Gadag, 29th September 1882,
SIR,
With reference to your Circular No. 4587 of 1882 and dated the 31st ultimo, I have
the honour to report that no case of undoubted enterie fever has come under my observation
among the native population,-at least none that has been verified by post-mortem exa-
mination.
2.    During the last few years, however, I have on rare occasions met with a few cases
among the out-door patients, which though returned as remittent fever might have been
well shown as those of enteric fever, that is, if the symptoms,  the progress and the compli-
cations were to be relied upon.    The most prominent,  and in a diagnostic point of view
the  chief complication has  been the  intestinal lesion  as   evidenced by   the  persistent
diarrhcea usually setting in during the 1st week of the occasion of the fever, with liquid
yellow pea-soup like stools, tinged now and then with blood, and the presence of gurgling
and pain in the right iliac fossa.    The other important complication was the lung lesion
in   the form of broncho-pneumonia of adynamic type supervening during the later stage
of the malady.    In no case however have I noticed any rose-coloured rash on the abdomen,
the back, and the chest; but taking the dark skin of the native population into considera-
tion, it is quite possible that this characteristic eruption may have escaped detection.    Nor
have I had the opportunity of verifying the diagnosis by an autopsy.    With regard to the
origin I have not been able to trace any connection with the  dejecta of those previously
affected with enteric fever; but judging from the meagre history usually furnished by the
native patients and their friends, malaria combined with insanitary conditions of the resi-
dence appeared to be the principal factor in the causation of the complaint.
3.    Cases of the so-called infantile remittent  fever are not commonly met with in this
country, but the few that  are occasionally  met with, with  marked intestinal  lesions,   can
probably be ascribed to modified enteric fever.    Most of the cases however among infants
and children returned as those of remittent type are undoubtedly of true remittent type, and
they can be usually traced to malarial origin.
I have the honour to be,
Sir,
Your most obedient Servant,
D. CARDOZ,
Assistant Surgeon, Gadag Dispensary."
"No. 164 OF 1882.
FROM
THE CIVIL SURGEON,
SURAT;
To
THE SECRETARY TO THE SURGEON GENERAL
WITH THE GOVERNMENT OF BOMBAY.
Civil Hospital, Surat, 13th September 1882.
SIR,
In reply to your Circular No. 4587, dated the 31st ultimo, I have the honour to report
that among the native population of the city of Dhárwár during the monsoon of 1881,
I attended five cases of what at the time appeared to me to be undoubted cases of typhoid
fever.
2.    None of them were hospital patients, and although I believe the disease prevailed
to a considerable extent in the city, no patient suffering from it sought relief in  the   civil
hospital.
3.    Besides the five cases referred to I saw, immediately before death, three cases
whose histories and condition led me to suspect that their disease might also be typhoid